16 Session  International Bioethics Committee

Social Responsibility and HealthMexico City

24 November, 2009

Universal Declaration on Bioethics and Human Rights UNESCO, 2005

Universal Declaration on Bioethics and Human Rights

Expresses the desirability of:“developing 

new 

approaches 

to 

social 

responsibility 

to 

ensure, 

whenever 

possible,  that 

progress 

in 

science 

and 

technology 

contributes 

to 

justice, 

equity 

and 

to 

the  interest of humanity”

12 Session Tokyo, December 2005

13 Session Paris, November 2006

14 Session Nairobi, May 2007

15 Session Paris, October 2008

Social Responsibility and Health

Working Group on Social Responsibility and Health  (2008‐2009)

• Members• Prof. (Mr) Diego GRACIA GUILLEN

(Spain)• Prof. (Mr) Gabriel O'EMPAIRE

(Venezuela)• Prof. (Mr) Donald EVANS 

(New Zealand)• Prof. (Mr) Sharat CHANORA

(India)• Prof. Martinez Palomo 

(Mexico)• Prof. (Mr) Stefano SEMPLlCI

(Italy)• Prof. (Mrs) Aïssatou TOURE 

(Senegal)• Prof. (Mrs) Monique WASUNNA 

(Kenya)• Prof. (Mr) Carter SNEAD 

(United States of America)• Prof. (Mrs) Sissel ROGNE 

(Norway)• Prof. (Ms) Olga KUBAR 

(Russian Federation)

IBC Report on Social Responsibility and Health

It does not pretend to be exhaustive nor 

prescriptive, and does not necessarily 

represent the views of the Member States of 

UNESCO

IBC Report on Social Responsibility and Health

The report has built upon work on public 

health 

issues 

by 

various 

international  bodies, 

in 

particular 

the 

World 

Health 

Organization

IBC Report on Social Responsibility and Health

It 

attempts 

to 

develop 

ethical 

and 

legal  dimensions 

of 

the 

principle 

and 

its 

relations 

to 

health, 

with 

the 

hope 

of  enriching 

future 

reflections 

on 

the 

real 

application 

of 

the 

principle 

of 

social  responsibility

International Initiatives in Promoting the Principle of Social Responsibility and Health

1947   Constitution of WHO1948   Universal Declaration of Human Rights1966  International Covenant on Economic, Social 

and Cultural Rights1977   Health‐for‐all by the Year 20001978   Alma Ata Declaration1996   Ljubljana Charter1997   Jakarta Declaration2005   Bankok Charter2000   UN Millenium Development Goals2005   Commission on Social Determinants of Health

Draft report (Sumitted to IBC in November 2009)

Life Expectancies: 2007

Preston curve

ource: Frances Brebner, 17 February 2003, TAG meeting –

Manilattp://w3.whosea.org/ehp/tag/pdf/hcf/INF3b.pdf

Land area

www.worldmapper.org

Public health spending

Territory size shows the 

proportion of worldwide 

spending on public health 

services that is spent there. 

This spending is measured in 

purchasing power parity.

• Territory  size shows the proportion of all people 

living in malaria regions worldwide

Malaria cases

http://www.childinfo.org/maternal_mortality_in_2000.pdf

90s’: The 90/10 gap identified

Only 10 percent of R&D spending is directed at the health problems of 90 percent of the world’s population.

Commission on  Health Research for DevelopmentCommission on  Health Research for Development

Proportion of all scientific papers published in 2001 written by authors living there

Inadequate research capacity

Global population growth, 1950–2050

Health Financing Revisited.

World Bank, 2006

Developing countries

Developed countries

Changing demographics

• New patterns

• Tipping point: 

2007 marks a turning point in 

human history: the world's 

urban population for the first 

time equals the world's rural 

population

Urbanization

Fragmentation in  international effort ….

Draft Report of the IBC on Social Responsibility and Health

I. IntroductionII. Ethical and legal dimensionsIII. Special areas of focusIV. Courses of action

i. Historical overviewii. Global health

conditions

Draft Report of the IBC on Social Responsibility and Health

II. Ethical and legal dimensions

a. Emergence of the notion of social responsibilityb. The notions of health and social developmentc. The status of health as a “good”d. Social responsibility, justice, solidarity and

equalitye. Relationship with other Articles of the

Declaration

Draft Report of the IBC on Social Responsibility and Health

III. Special areas of focus

a. Health careb. Researchc. Industryd. Education

Draft Report of the IBC on Social Responsibility and Health

IV. Courses of action

a. Decision-making proceduresb. Transnational scopec. National bioethics committeesd. Quality assurance in health caree. Global health risks

Climate changePandemicsFood shortages

Conclusions

1. In spite of advances in the Millenium 

Development Goals, these will not be achieved by  2015

2. Therefore, there is an urgent need to increase the 

ethical and social responsibility of countries,  communities and individuals for the goal of 

improving health

Health Equity Through Action on the Social Determinants of Health, 2008

Commission on Social Determinants of Health WHO, 2008

• In 

countries 

at 

all 

levels 

the 

lower 

the  socioeconomic 

position, 

the 

worse 

the 

health

• It 

does 

not 

have 

to 

be 

this 

way, 

reducing  health inequities is an ethical imperative

IIndependent opinions……

“It is not inequalities that kill people, it is those who are responsible for these

inequalities that kill people”

Navarro V, Int J Health Serv 39:423, 2009